Medicaid expansion
What is Medicaid expansion?
Medicaid expansion is a state's adoption of the ACA option to cover all adults with income up to 138% of the federal poverty level. In most non-expansion states, adults must fit a category — such as pregnancy, disability, or caring for a child — because low income alone does not qualify them. Wisconsin is the exception: it did not expand but covers adults on income up to 100% of the federal poverty level.
Expansion status is the single biggest factor in whether Medicaid survives an interstate move. Moving from an expansion state to most non-expansion states can end an adult's eligibility entirely, even at the same income.
In that direction, the fallback is usually a marketplace plan on HealthCare.gov, where losing Medicaid is a qualifying event for a special enrollment period.
From January 1, 2027 (earlier in some states), federal law (Public Law 119-21) also requires most expansion adults to show 80 hours a month of work, school, job training, or community service unless they are exempt.